Vyas N, Agarwal S, Shah N, Patel D, Aapaliya P
Department of Oral and Maxillofacial Surgery, Ahmedabad Dental College and Hospital, Gujarat, India.
Department of Public Health Dentistry, Pacific, Dental College and Hospital, Rajasthan, India.
Kathmandu Univ Med J (KUMJ). 2014 Jan-Mar;12(45):4-8. doi: 10.3126/kumj.v12i1.13625.
Lower impacted third molar surgical extraction usually causes post-surgical sequelae like pain, trismus and swelling as a result of postoperative inflammatory response.
The aim of this study was to evaluate and compare the efficacy of single dose 40-mg (1 cc) of methylprednisolone acetate, injected into the masseter muscle, preoperatively one hour before the surgery or post-operatively, immediately following the surgical removal of impacted lower third molars, in controlling most common postoperative sequelae, i.e. trismus, pain and swelling of facial soft tissue.
A randomized control study was done of 60 patients. Each patient was categorized in two groups, group I and group II, according to the time of receiving methylprednisolone acetate. Group I was injected 40 mg of methylprednisolone acetate into the masseter muscle via the intrabuccal approach, one hour before the surgery. Group II was injected 40 mg of methylprednisolone acetate into the masseter muscle via the intrabuccal approach, immediately after suturing of the surgical wound. The washout period was one month after the first operation. Evaluation were made of postoperative pain, trismus and swelling. The numeric pain scale (NPS) was used for pain assessment.
When the patients were administered methylprednisolone acetate preoperatively, showed superior results in terms of oral aperture, pain and all the facial swelling parameters, with statistically significant differences versus the postoperatively administered methylprednisolone acetate (p < 0.05).
A single dose of 40 mg (1 cc) methylprednisolone acetate injected into the masseter muscle preoperatively is more effective in reducing pain, trismus and swelling, when compared to that administered postoperatively.
下颌低位阻生第三磨牙手术拔除后，术后炎症反应通常会导致疼痛、张口受限和肿胀等手术后遗症。
本研究旨在评估并比较在拔除下颌低位阻生第三磨牙术前1小时或术后立即向咬肌注射单剂量40mg（1cc）醋酸甲泼尼龙，对控制最常见的术后后遗症（即张口受限、疼痛和面部软组织肿胀）的疗效。
对60例患者进行随机对照研究。根据接受醋酸甲泼尼龙的时间，将每位患者分为两组，即I组和II组。I组在手术前1小时通过颊内途径向咬肌注射40mg醋酸甲泼尼龙。II组在手术伤口缝合后立即通过颊内途径向咬肌注射40mg醋酸甲泼尼龙。洗脱期为首次手术后1个月。对术后疼痛、张口受限和肿胀进行评估。采用数字疼痛量表（NPS）进行疼痛评估。
术前给予醋酸甲泼尼龙的患者在开口度、疼痛和所有面部肿胀参数方面显示出更好的结果，与术后给予醋酸甲泼尼龙相比，差异有统计学意义（p<0.05）。
与术后给药相比，术前向咬肌注射单剂量40mg（1cc）醋酸甲泼尼龙在减轻疼痛、张口受限和肿胀方面更有效。
